Item request has been placed! ×
Item request cannot be made. ×
loading  Processing Request

Avoiding Unintended Incentives In ACO Payment Models.

Item request has been placed! ×
Item request cannot be made. ×
loading   Processing Request
  • Additional Information
    • Subject Terms:
    • NAICS/Industry Codes:
      923130 Administration of Human Resource Programs (except Education, Public Health, and Veterans' Affairs Programs)
    • Abstract:
      One goal of the Medicare Shared Savings Program for accountable care organizations (ACOs) is to reduce Medicare spending for ACOs' patients relative to the organizations' spending history. However, we found that current rules for setting ACO spending targets (or benchmarks) diminish ACOs' incentives to generate savings and may even encourage higher instead of lower Medicare spending. Spending in the three years before ACOs enter or renew a contract is weighted unequally in the benchmark calculation, with a high weight of 0.6 given to the year just before a new contract starts. Thus, ACOs have incentives to increase spending in that year to inflate their benchmark for future years and thereby make it easier to obtain shared savings from Medicare in the new contract period. We suggest strategies to improve incentives for ACOs, including changes to the weights used to determine benchmarks and new payment models that base an ACO’s spending target not only on its own past performance but also on the performance of other ACOs or Medicare providers. [ABSTRACT FROM AUTHOR]
    • Abstract:
      Copyright of Health Affairs is the property of Project HOPE/HEALTH AFFAIRS and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
    • Author Affiliations:
      1Health economist, CPB Netherlands Bureau for Economic Policy Analysis, The Hague, Netherlands
      2Health economist. CPB Netherlands Bureau for Economic Policy Analysis, Erasmus University Rotterdam, Netherlands
      3Professor, health economics, Harvard Medical School, Boston, Massachusetts
      4Associate professor, health care policy and medicine, Harvard Medical School and Brigham and Women's Hospital, Boston
    • ISSN:
      0278-2715
    • Accession Number:
      10.1377/hlthaff.2014.0444
    • Accession Number:
      100345975
  • Citations
    • ABNT:
      DOUVEN, R.; MCGUIRE, T. G.; MCWILLIAMS, J. M. Avoiding Unintended Incentives In ACO Payment Models. Health Affairs, [s. l.], v. 34, n. 1, p. 142–149, 2015. DOI 10.1377/hlthaff.2014.0444. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=asn&AN=100345975&custid=s8280428. Acesso em: 9 ago. 2020.
    • AMA:
      Douven R, McGuire TG, McWilliams JM. Avoiding Unintended Incentives In ACO Payment Models. Health Affairs. 2015;34(1):142-149. doi:10.1377/hlthaff.2014.0444
    • APA:
      Douven, R., McGuire, T. G., & McWilliams, J. M. (2015). Avoiding Unintended Incentives In ACO Payment Models. Health Affairs, 34(1), 142–149. https://doi.org/10.1377/hlthaff.2014.0444
    • Chicago/Turabian: Author-Date:
      Douven, Rudy, Thomas G. McGuire, and J. Michael McWilliams. 2015. “Avoiding Unintended Incentives In ACO Payment Models.” Health Affairs 34 (1): 142–49. doi:10.1377/hlthaff.2014.0444.
    • Harvard:
      Douven, R., McGuire, T. G. and McWilliams, J. M. (2015) ‘Avoiding Unintended Incentives In ACO Payment Models’, Health Affairs, 34(1), pp. 142–149. doi: 10.1377/hlthaff.2014.0444.
    • Harvard: Australian:
      Douven, R, McGuire, TG & McWilliams, JM 2015, ‘Avoiding Unintended Incentives In ACO Payment Models’, Health Affairs, vol. 34, no. 1, pp. 142–149, viewed 9 August 2020, .
    • MLA:
      Douven, Rudy, et al. “Avoiding Unintended Incentives In ACO Payment Models.” Health Affairs, vol. 34, no. 1, Jan. 2015, pp. 142–149. EBSCOhost, doi:10.1377/hlthaff.2014.0444.
    • Chicago/Turabian: Humanities:
      Douven, Rudy, Thomas G. McGuire, and J. Michael McWilliams. “Avoiding Unintended Incentives In ACO Payment Models.” Health Affairs 34, no. 1 (January 2015): 142–49. doi:10.1377/hlthaff.2014.0444.
    • Vancouver/ICMJE:
      Douven R, McGuire TG, McWilliams JM. Avoiding Unintended Incentives In ACO Payment Models. Health Affairs [Internet]. 2015 Jan [cited 2020 Aug 9];34(1):142–9. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=asn&AN=100345975&custid=s8280428